Annali dell'Istituto Superiore di Sanità
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Comparison of corticosterone responses to acute stress in mice following different serial blood collection methods
Full text linkBackground. Accurate evaluation of glucocorticoid concentrations during serial blood collection in rodents is often hampered by the stress response elicited by the procedure itself. The optimal method to minimize stress and impact on animal welfare remains debated.Methods. Hence, we compared corticosterone concentrations in adult mice serially bled by using the retro-orbital sinus puncture or the tail vein incision methods, either with or without exposure to an acute restraint stress.Results. Corticosterone concentrations were significantly affected by the sampling method, with higher peaks and sustained hypercortisolemia in mice bled with the retroorbital sinus puncture, pointing to the tail vein incision method as preferable for serial blood collections. Mice bled using the tail vein incision reached similar corticosterone peaks regardless of exposure to acute stress.Conclusions. Our findings suggest that tail vein incision can be used to evaluate neuroendocrine reactivity without exposing mice to restraint procedures. This would improve animal welfare practices in experimental protocols
Comparing results from a traditional multivariable model and seven propensity score-based models for estimating COVID-19 vaccine effectiveness
Full text linkBackground. Accurate estimation of vaccine effectiveness (VE) in real-world settings is essential for guiding immunization strategies, especially in older populations. However, observational studies are prone to bias due to confounding factors, and the choice of statistical method can significantly influence VE estimates.Materials and methods. We compared the performance of a multivariable Cox proportional hazards model with seven propensity score (PS)-based models to estimate the relative vaccine effectiveness (rVE) of the bivalent Original/Omicron BA.4-5 mRNA vaccine as a second or third booster, compared to a first mRNA booster received ≥120 days earlier. Data from 11,879,461 individuals aged ≥60 in Italy (April-June 2023) were analyzed.Results. All models produced consistent rVE estimates, with values ranging from 16.4% to 22.1%. Over time, booster effectiveness declined, with the reference model showing a drop in rVE from 45.6% (15-60 days) to 14.3% (181-265 days). PS-based methods improved covariate balance but did not outperform the Cox model in terms of precision or interpretability.Conclusions. In large, relatively balanced datasets, traditional multivariable models remain a robust and reliable choice for estimating VE. While PS-based methods offer theoretical advantages, their practical benefit may be limited when confounding is well controlled
Can we trust administrative data in joint arthroplasty? A Validation study against the Italian Arthroplasty Registry data as a gold standard
Full text linkIntroduction. Hospital Discharge Data (HDD) can be a valuable source of information for epidemiological research, but in Italy its accuracy in arthroplasty has not yet been determined on a large scale. The aim is to assess Italian HDD accuracy in reporting clinical information on hip/knee arthroplasties, using RIAP data collected by the Italian Arthroplasty Registry (RIAP) as a reference.Methods. Coding systems for procedures and diagnoses in RIAP data and HDD for years 2007-2021 are mapped to a common list of items describing surgical procedures and related diagnoses. The ability of HDD in predicting procedures and diagnoses is evaluated by sensitivity, specificity and accuracy, while using RIAP data as a reference.Results. Surgical procedures and causes for elective and urgent arthroplasties are predicted by HDD with at least 96% sensitivity. Performances drop when evaluating procedures and diagnoses at fine-grain level and for rare events.Discussion. HDD reports reliable clinical information in arthroplasty and is an effective tool for epidemiological purposes. Nonetheless, a cautious approach must be considered when dealing with high-detail and rare event
“Undiagnosed” severe disease pseudo-outbreaks in Sub-Saharan Africa: a paradigm of syndemic events
Full text linkAbstract
Several outbreaks of undiagnosed severe disease occurred in the Democratic Republic of Congo over the last year. Although this is not completely unusual, at least one of them raised an international concern until the determinants of the excess death were identified. Far from representing a real threat for people living in wealthy countries, most of these events are context related, and mainly due to a combination of poverty-related conditions, such as malnutrition, historic plagues like malaria, and vulnerability to common respiratory infections. Even though these syndemic events remain usually restricted to well defined geographical areas affected by poor resources, they merit attention since they represent an opportunity to improve health conditions in remote areas and a challenge to strengthen global preparedness against pandemic events.
Lymphedema and psychosocial well-being: a mixed-methods exploration of resources and challenges in the Italian context
Full text linkIntroduction. Individuals affected by lymphedema, both primary and secondary, experience a significant reduction in quality of life and functional capacity. However, the impact of lymphedema on occupational life, specifically on return-to-work processes, remains largely unexplored.Objectives. This study explores the psychosocial, occupational, and health-related challenges experienced by individuals with lymphedema, with a focus on work reintegration.Methods. A mixed-method approach was adopted through the development of an online survey, which included both standardized psychometric scales and open-ended questions.Results. The mediation analysis confirmed that return to work self-efficacy serves as a key mechanism through which optimism contributes to job satisfaction. Qualitative findings highlight the need for multilevel and systemic interventions. From an individual perspective, targeted self-efficacy training programs for workers with lymphedema appear crucial.Conclusions. Considering a community and an organizational perspective, it is essential to implement training initiatives for healthcare professionals aimed at improving their knowledge and awareness of lymphedema
Acknowledgement to Referees
Full text linkThis section acknowledges the referees who reviewed papers for the Annali ISS between January and December 2025. These referees played a critical role in maintaining the journal\u27s quality standards, ensuring that published papers meet rigorous academic criteri
Ten years after Regulation 536/2014: ethical reflection on the role of Ethics Committees in Italy
Full text linkSince their institution, Ethics Committees (ECs) dedicated to the ethical evaluation of research protocols have been traditionally entrusted with the role of finding a delicate balance between protecting research participants’ rights and avoiding the hampering ofscientific progress. In Europe, these bodies have evolved significantly over time, shaped by a dynamic regulatory framework culminating in Regulation (EU) 536/2014, which has been fully applied since 2022. Focusing on the Italian scenario, a decade after theadoption of the Regulation (2014-2024), this paper is aimed at shedding light on the extent to which the evolution of the pertinent normative framework has affected ECs’ space for reflection within the ethics review process of clinical trials, essential to protectthe rights of research participants. Although focused on the Italian scenario, the analysis holds relevance for the broader European context, since the Regulation is unique and developments in a single Member State may impact the others
Description of an onsite school-based intervention aimed at increasing influenza vaccination uptake among children in an Italian Local Health Authority
Full text linkIntroduction. Onsite school-based intervention represents a key strategy to increase influenza vaccination uptake and improve knowledge of children, parents and school staff. This study aims to quantitatively describe an intervention in Local Health Authority Roma 1.
Methods. Vaccination was offered to children aged 2-6 years. A quantitative descriptive analysis of vaccination coverage and population variables was performed.
Results. 29 schools were included. Out of 2,424 eligible children, 405 were vaccinated (16.7%). Of these, 218 (53.8%) were male and 187 (46.2%) female, mean age 4.4 years old. 177 (43.7%) received one dose, while 228 (56.3%) were vaccinated for the first time. Of these, 150 students (65.8%) also received the second dose. 148 other people (parents, teachers and older children) decided to join the campaign, thus being vaccinated.
Conclusion. Community-based interventions in school settings increase adherence to health promotion campaigns. It is necessary to continue researching and investing in such activitie
Publications from International Organizations on Public Health
Full text linkThe Publications from International Organizations on Public Health section includes a wider selection of the most recent publications edited by the main international organizations active in the field of public health, such as: the European Food Safety Authority (EFSA), the Food and Agriculture Organization of the United Nations (FAO), the International Labour Organization (ILO), the Organisation for Economic Co-operation and Development (OECD), the United Nations Educational, Scientific and Cultural Organization (UNESCO), the United Nations Environment Programme (UNEP), the United Nations Programme on HIV/AIDS (UNAIDS), and the World Health Organization (WHO)
A preliminary study of the effects of transformations induced by gammaray treatment on the detection of Acheta domesticus and Tenebrio molitor allergenic proteins by enzyme-linked immunosorbent assay (ELISA) techniques
Full text linkIntroduction. With the global population projected to reach approximately 9 billion by 2050, there’s a growing need to explore alternative food sources. Insects have emerged as a potential solution to meet food demand, offering a substitute for conventional livestock. However, a primary safety concern surrounding these novel foods is their allergenic potential, especially given the absence of standardized testing methodologies. Tomitigate this risk, food irradiation has been explored as a method to reduce allergenicity in insects intended for human and animal consumption.Material and methods. This study utilized an enzyme-linked immunosorbent assay to determine the allergenic proteins in specific insect types after irradiation treatment.Results and discussion. Significant differences in detectable protein levels were observed between Tenebrio molitor and Acheta domesticus samples, but no significant differences in protein content were found between food and feed samples of both species under identical irradiation conditions. Further research is required to ensure the protocol’s suitability for more complex food matrices